化痰降浊汤对高脂血症血脂的影响

目的观察化痰降浊汤对高脂血症患者血脂的影响。方法选取60例患者,予化痰降浊汤口服(药物组成:泽泻15 g,山楂10 g,陈皮20 g。水煎取汁150 mL。消毒,灭菌,4℃保存备用),1次/d,连续30 d。结果服用化痰降浊汤后,总胆固醇、三酰甘油、低密度脂蛋白胆固醇指标均下降,高密度脂蛋白胆固醇指标上调。结论化痰降浊汤具有调节血脂的作用。     

Fortification of flours with folic acid reduces homocysteine levels in Brazilian women

Our hypothesis is that the fortification of flour with folic acid contributes to the reduction of plasma homocysteine (Hcy). We conducted a cross-sectional study covering 2 periods, before and after fortification (2002-2003 and 2008-2009, respectively), to assess the influence of the consumption of corn and wheat flours prefortification and postfortification with folic acid on Hcy levels and other biomarkers. In the total, 93 women (38 prefortification and 55 postfortification) were included. Levels of lipids and glucose, total Hcy and serum folate, and cobalamin were determined using commercial kits by colorimetric method, competitive immunoassay, and chemiluminescence, respectively The participants' average age was 48.1 ± 9.5 years for the prefortification group and 39.1 ± 4.1 years for the postfortification group (P < .001) but adjusted statistical tests by age. Both groups presented obesity class 1. In the prefortification group, 71.1% (n = 27) of women had a dietary intake of folate, which was lower than the current recommended for adults (<400 μg/d), whereas in the postfortification group, only 16.4% (n = 9) of women had lower intakes than recommended. In the prefortification group, 42.1% (n = 16) of women had hyperhomocysteinemia (>10 mmol/L) compared with only 9.1% (n = 5) in the postfortification group. Moreover, statistically significant differences were found between the 2 groups in total cholesterol, high-density lipoprotein, triglycerides, and dietary fiber. Our findings corroborate the hypothesis that fortification of wheat and corn flours with folic acid can possibly be associated with lower concentrations of plasma Hcy, providing probable greater cardiovascular protection in this group.     

胆固醇/高密度脂蛋白-胆固醇比值在脑梗死中的价值研究

目的:探讨胆固醇/高密度脂蛋白-胆固醇比值(TC/HDL-C比值)与脑梗死发病危险性的关系以及这一比值在脑梗死患者合并高血压或糖尿病时的变化。方法:选择197例脑梗死患者分为三组:单纯脑梗死组、合并高血压组、合并糖尿病组。58例健康者作为正常对照组,探讨这一比值的变化。结果:胆固醇(TC)水平及TC/HDL-C比值在脑梗死患者与正常对照组间有显著性差异(P<0.05);脑梗死患者的HDL-C水平较正常对照组降低,但两者差异无显著性(P>0.05);不同病例组间TC、HDL-C水平及TC/HDL-C比值无显著性差异(P>0.05)。结论:TC/HDL-C比值是脑梗死的危险因素,与高血压、糖尿病无关。     

Nonlinear relation between alcohol intake and high-density lipoprotein cholesterol level: results from the Copenhagen City Heart Study

BACKGROUND: It has been suggested that the level of high-density lipoprotein cholesterol (HDL-C) in the blood can be used as a marker of recent alcohol intake. However, before using HDL-C as a predictor of alcoholism, the relation between alcohol intake and HDL-C in the entire range of consumption must be explored. Most studies model the relation between alcohol intake and HDL-C linearly, although a threshold effect is expected. The objective of this study was to evaluate the shape of the relation between intake of alcohol and HDL-C and to determine whether there are differential effects of beer, wine, and spirits on HDL-C and whether they remain after adjusting for total alcohol. METHOD: The relation between alcohol intake and HDL-C was investigated by means of generalized additive models using data from the Copenhagen City Heart Study. RESULTS: A nonlinear effect of alcohol improved the model fit significantly, and the nonlinearity of alcohol was highly significant in both men and women. The relation was concave: HDL-C was stable in men and women who drank more than approximately 35 and 20 drinks per week, respectively. We found a significant nonlinear term of wine on HDL-C in men after adjustment for total alcohol intake. CONCLUSIONS: There was a concave relation between alcohol intake and HDL-C, indicating a threshold effect of alcohol on HDL-C. The association between wine and HDL-C in men after adjusting for total alcohol intake may be due to residual lifestyle confounding.     

动脉粥样硬化性脑梗死患者血脂分析

目的探讨血脂异常血症与动脉粥样硬化性脑梗死的关系。方法指标TCH、TG采用酶法检测，HDL—C、LDL—C采用磷钨酸-镁沉淀法检测。结果患病组与对照组血脂四项检测结果比较差异有显著性（P〈0．01）。结论血脂异常与动脉粥样硬化性脑梗死的发生有密切的关联，是动脉粥样硬化性病变形成的必要因素，注意脂类的合理摄入是预防和治疗动脉粥样硬化性脑梗死的重要方面。     

TC和TG均正常的人群高／低密度脂蛋白胆固醇水平分析

目的了解总胆固醇（TC）和甘油三酯（TG）均处于合适范围的人群高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平，提高对HDL-C和LDL-C检测的重视，从而较全面地筛选出血脂异常。方法根据2007年《中国成人血脂异常防治指南》标准，从学校4021名健康体检人群中筛选出1587例TC和TG均处于正常水平的人群，进行HDL-C和LDL—C的统计分析。结果正常TC和TG人群中，HDL—C降低占6．24％，LDL-C边缘升高检出率为12．35％，LDL-C升高检出率为1．64％。其中男性分别为8．82％、16．00％、2．77％；女性分别为2．12％、6．54％、0．65％，男性均高于女性（p〈0．01），女性在50岁以后HDL-C和LDL—C异常的检出率明显上升。结论TC、TG两项指标均处于合适范围的人群仍可能存在HDL—C的降低和LDL-C的边缘升高或升高。临床医师和实验室人员应高度重视HDL-C和LDL—C的检测。     

Effect of atorvastatin upon platelet activation in hypercholesterolemia, evaluated by flow cytometry

Hyperlipidemia is a well established risk factor for cardiovascular disease and atherothrombotic events, in which platelet activation also plays a significant role. However, very few studies have addressed platelet activation in hypercholesterolemia, the potential effect of lipid lowering drugs upon platelet hyperfunction, and the question of whether changes in the latter are correlated to normalization of plasma lipids. This study used whole blood flow cytometry to assess in vivo and in vitro platelet activation in a group of 33 patients with hypercholesterolemia, and also the ex vivo effect of atorvastatin (20 mg/day) upon such activation. A control group of 40 normolipidemic volunteers matched in terms of age, sex and added risk factors to the patient group was used. The results showed that hypercholesterolemic patients had in vivo a significantly greater percentage of GPIIb/IIIa- and phosphatidylserine-positive platelets compared with the control group (4.62+/-3.51% and 2.58+/-1.19% versus 2.73+/-1.08% and 1.54+/-0.68%, respectively). In vitro response of CD62 expression to thrombin was also greater in the patients than in the controls (92.51+/-6.00% versus 89.63+/-10.72%, p<0.05). Atorvastatin therapy normalized platelet hyperfunction in the patients studied and reduced GPIIb/IIIa response to ADP (from 82.65+/-6.43% to 75.84+/-4.89%, p<0.01). A significant correlation can be seen between such normalization and the decrease in plasma levels of total and LDL cholesterol.     

Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents

OBJECTIVE: To determine prevalence of metabolic syndrome (MS) among adolescents by using definitions from the National Cholesterol Education Program Adult Treatment Panel III (NCEP) and World Health Organization (WHO) guidelines and to compare the populations identified by these definitions. STUDY DESIGN: School-based, cross-sectional study of 1513 black, white, and Hispanic teens who had a fasting morning blood sample drawn and a physical examination. RESULTS: Overall, the prevalence of NCEP-defined MS was 4.2% and of WHO-defined MS was 8.4%. MS was found almost exclusively among obese teens, for whom prevalence of NCEP-defined MS was 19.5% and prevalence of WHO-defined MS was 38.9%. Agreement between definitions was poor (kappa statistic=0.41). No race or sex differences were present for NCEP-defined MS. However, nonwhite teens were more likely to have MS by WHO criteria (RR, 1.40; 95% CI, 1.04, 1.87), and MS was more common among girls if the WHO-based definition was used (RR, 1.26; 95% CI, 1.08, 1.88). CONCLUSIONS: Among adolescents, obesity is a powerful risk for MS. Important demographic and clinical differences exist in the typology of MS, depending on the definition. Such discrepancies suggest that the concept of a common pathologic syndrome or etiologic mechanism underlying MS as defined by these guidelines may be flawed.     

The value of serum albumin and high-density lipoprotein cholesterol in defining mortality risk in older persons with low serum cholesterol

OBJECTIVES: To investigate the relationship between low cholesterol and mortality in older persons to identify, using information collected at a single point in time, subgroups of persons with low and high mortality risk. DESIGN: Prospective cohort study with a median follow-up period of 4.9 years. SETTINGS: East Boston, Massachusetts; New Haven, Connecticut; and Iowa and Washington counties, Iowa. PARTICIPANTS: Four thousand one hundred twenty-eight participants (64% women) age 70 and older at baseline (mean 78.7 years, range 70-103); 393 (9.5%) had low cholesterol, defined as < or =160 mg/dl. MEASUREMENTS: All-cause mortality and mortality not related to coronary heart disease and ischemic stroke. RESULTS: During the follow-up period there were 1,117 deaths. After adjustment for age and gender, persons with low cholesterol had significantly higher mortality than those with normal and high cholesterol. Among subjects with low cholesterol, those with albumin> 38 g/L had a significant risk reduction compared with those with albumin < or =38 g/L (relative risk (RR) = 0.57; 95% confidence interval (CI) = 0.41-0.79). Within the higher albumin group, high-density lipoprotein cholesterol (HDL-C) level further identified two subgroups of subjects with different risks; participants with HDL-C <47 mg/dl had a 32% risk reduction (RR = 0.68; 95% CI = 0.47-0.99) and those with HDL-C > or =47 mg/dl had a 62% risk reduction (RR = 0.38; 95% CI = 0.20-0.68), compared with the reference category; those with albumin < or =38 g/L and HDL-C <47 mg/dl. CONCLUSIONS: Older persons with low cholesterol constitute a heterogeneous group with regard to health characteristics and mortality risk. Serum albumin and HDL-C can be routinely used in older patients with low cholesterol to distinguish three subgroups with different prognoses: (1) high risk (low albumin), (2) intermediate risk (high albumin and low HDL-C), and (3) low risk (high albumin and high HDL-C).